Macular Structures and Microcirculation in Posterior Staphyloma with Young High Myopia

Introduction: To investigate the macular structures and microcirculation characteristics in young patients with high myopia (HM) and posterior staphyloma (PS). Methods A total of 135 eyes from 135 participants were included. The HM patients were divided into no PS (NPS) and PS groups. The macular structures and microcirculation parameters were acquired using optical coherence tomography (OCT) and OCT angiography (OCTA). Linear regression and pearson’s correlation analysis were used to determine the relationships among measurements. Results The macular area was divided into foveal, superior, nasal, inferior, and temporal regions. The superior and inferior retinal thickness in the PS group decreased significantly in the NPS and PS groups. This study demonstrated a correlation between retinal vascular density (RVD), age, refraction, axial length (AL) and intraocular pressure (IOP) in the two groups. The temporal RVD decreased significantly with the increase of AL (beta = -0.603; P = 0.026) in the NPS group. The fovea AL increased significantly with the increase of retinal thickness (RT) (beta = 3.916; P = 0.036) in the NPS group. The RVD decreased significantly with the increase of inferior refraction (beta = -0.42; P = 0.033) in the PS group. The temporal RVD decreased significantly with the increase of AL (beta = -1.344; P = 0.038) in the PS group. The fovea RT increased significantly with the increase of AL (beta = 8.83; P = 0.007) in the PS group. The linear regression in NPS group showed the correlation between the RVD and RD in the macular fovea region (R = 0.42; P < 0.001). Conclusions The inferior retina may be particularly susceptible to RVD due to changes in scleral curvature and regional mechanical stress within the posterior segment of the HM. The posterior staphyloma exacerbates retinal thinning and vascular density reduction in specific regions, potentially contributing to the progression of retinal dysfunction in patients with high myopia.